Surgical instrument



March 19, 1963 J. M. HUNTER SURGICAL INSTRUMENT Filed Sept. 21, 1960 4 Sheets-Sheet 1 IO\ I8 FIG.I

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INVENTOR JOHN M. HUNTER KENWMY, JENNEY & HILERETH ATTORNEYS Man}! 19, 1963 J. M. HUNTER 3,081,770

SURGICAL INSTRUMENT Filed Sept. 21, 1960 70 8 I 1" L r) FIG. 9

86 INVENTOR JOHN M. HUNTER BY KENWAY, JENNEY & HILDRETH ATTOR NEYS 4 SheetS- Sheet 2 March 19, M, HUNT SURGICAL INSTRUMENT 4 Sheets-Sheet 3 Filed Sept. 21, 1960 FIG. I5

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S uh--- INVENTOR. JOHN M. HUNTER KEIIWAY, IEIINEY 8 HILDREIH' ATTOR N EYS March 19, 1963 J. M. HUNTER 3, 0

SURGICAL INSTRUMENT FiledSept. 21, 1960 4 Sheets-Sheet 4 H6) FIG. l4

INVENTOR JOHN M. HUNTER I74 BY KENWAY, JENNEY 8. HI'LDREIH ATTORNEYS United States Patent 3,081,770 SURGICAL INSTRUMENT John M. Hunter, 27 Forest St, Mitten, Mass. Filed Sept. 21, 1960, Ser. No. 57,481 12 Claims. (Cl. 128-221) This invention relates to surgical instruments and more particularly comprises a new and improved surgical needle for simultaneously injecting and extracting fluids from the human body. This invention also includes a novel arrangement for readily determining fluid pressure within a body cavity.

In view of the fact that only a small percentage of tumors or other lesions of the brain give evidence of their presence from clinical examination, a series of diagnostic tests have been developed by which pathology of the brain and spinal cord may be more easily discovered. Under present diagnostic practice, the fluid within the ventricular cavities of the brain is drawn off either by a needle inserted into a ventricular cavity of the brain and inserted through a small hole drilled in the skull or by a needle inserted into the spinal subarachnoid space (lumbar puncture). In each instance, the cerebrospinal fluid is replaced by a gas such as air or oxygen. From a series of X-ray picture's made of the head or spinal cord under these conditions, (encephalogram, ventriculogram, or air myelograrn) it is possible to diagnose and accurately localize lesions such as tumors, cysts, abscesses or scar which usually distort the configuration of the ventricular system of the brain or the cerebrospinal fluid pathways.

When a tumor, cyst, abscess or fractured bone appears in the vicinity of the spinal column, it may cause a blockage of the subarachnoid space either by its own bulk or by compressing the membranes against one another should it be extradural. This blockage can be detected in several ways, one of which involve the compressing of the jugular veins. The consequent rise of intracranial venous pressure is transmitted to the cerebrospinal fluid and can be measured by a manometer attached to a lumbar puncture needle. If a tumor blocks the cerebrospinal fluid flow, the manometer will record little or no change depending on the degree of blockage. Another method of detecting the degree and location of a blockage involves draining a portion of the spinal fluid and injecting a quantity of air into the spinal subarachnoid space (air myelogram). Any unnatural obstruction will show up clearly in the resulting X-ray pictures taken of the spine.

In the technique of a lumbar puncture, it is often extremely important to the patients survival that no spinal fluid be lost. In spinal encephalography, it is equally important that an even physiological pressure be maintained within the subarachnoid space and ventricular system. In ventriculography in particular, it is important that displacement of the needle be avoided once the puncture of the brain has been made, otherwise a brain laceration may readily result. In lumbar punctures it is important that no displacement of the needle tip occurs, otherwise the spinal cord or its roots may be damaged.

It is an object of the present invention to provide an improved surgical needle for use in draining body fluids while simultaneously injecting a quantity of gas or diagnostic or medicinal fluid.

Another object of this invention is to provide a surgical needle arranged to indicate body fluid pressure at any given moment.

Yet, another object of this invention is to provide a surgical instrument having a plurality of interchangeable elements whereby the instrument may be adapted to perform a variety of functions without any displacement or removal of the main portion of the instrument from its operating position.

3,681,770 Patented Mar. 19, 1963 More particularly, this invention features a valve housing adapted to support a hollow needle with a second hollow needle mountable within the first and connected with a removable valve member. One or more conduits are connected to the housing so that should air or other fluids be injected through the inner needle, into a ventricular chamber for example, the ventricular fluid may be drained off through the annular passage existing between the inner and the outer needles.

The invention also features a connecting arrangement having a pressure-indicating device, such as a manometer, whereby the pressure of a body fluid may be quickly determined by operation of the valve member.

As another feature of this invention, the instrument is arranged so that various components are movable about or along the axis of the needle, thereby eliminating the possibility of any lateral or other displacement of the needle when in situ.

These and other novel features of the invention, to gether with further objects and advantages thereof will become apparent from the following detailed specification with reference being made to the accompanying drawings in which;

FIG. 1 is a View in side elevation of the valve housing and outer needle of a lumbar puncture instrument made according to my invention,

. FIG. 2 is a side elevation of a stylet for use in the device of FIG. 1,

FIG. 3 is a view in side elevation of a removable valve member and inner needle for insertion in the housing and needle of FIG. 1,

FIG. 4 is a cross-section View in side elevation of Ian assembled lumbar puncture needle,

FIG. 5 is a detailed cross-section view taken along the line 55 of FIG. 4,

FIG. 6 is a fragmentary view in side elevation showing :a modification of a removable valve member for use in place of the member shown in FIG. 3.

FIG. 7 is a sectional view in side elevation showing a portion of the valve housing of FIG. 1, and a modified removable valve member mounted therein,

FIG. 8 is a side elevation of a stylet for use in the FIG. 7 embodiment,

FIG. 9 is a sectional view in side elevation of a ventricular puncture needle made according to this. invention,

FIG. 10 is a view in side elevation of a stylet for use in the needle shown in FIG. 9.

FIG. 11 is a sectional view in side elevation of an aspiration and irrigation needle rnade according to this invention,

FIG. 12 is a fragmentary view of the needle tip shown in FIG. 11 and on an enlarged scale,

FIG. 13 is a cross-sectional view taken along the line 1313 of FIG. 12,

FIG. 14 is a view in side elevation of a stylet for use in the FIG. 11 device.

FIG. 15 is a view in side elevation of a modified lumbar puncture needle,

FIGS. 16a, 16b, and are cross-sectional views taken along the line 16'16 of FIG. 15 and showing the various operating positions of the needle,

FIG. 17 shows a further modification of the lumbar puncture needle,

FIG. 18 shows a lumbar puncture needle with a retractable tip,

FIG. 19 is a detail view in side elevation of a novel needle tip suitable for use on certain of these surgical needles,

FIG. 20 is an end view of the tip shown in FIG. 19,

FIG. 21 is a view similar to that of FIG. 19 showing a modification of the tip, 1

FIG. 22 is an end view of the needle of FIG. 21, and

FIG. 23 is a bottom plan view thereof.

Referring now to the drawings, the various parts of the lumbar puncture needle illustrated in FIGS. 1ll are organized about a valve housing or hub 10 having a frusto-conical chamber 12 formed axially therein. A cylindrical passage of somewhat smaller diameter than the chamber 12, is in communication with the chamber and is adapted to accommodate one end of a tubular surgical needle 14. Although the needle is shown permanently attached to the hub, it will be understood that it may be detachably connected for replacement purposes if desired. The housing 10 is formed with two tubular extensions 18 and 20 having passages 22 and 24 respectively formed therein and communicating with the chamber 12.

In FIG. 2 there is illustrated a stylet 26 having a solid shaft 28 of circular cross section dimensioned to fit snugly Within the needle v14. A knob or head 38 is provided for grasping the stylet. In practice, when the lumbar puncture needle of FIG. 1 is to be inserted in the body, the stylet is first slipped through the housing 10 so that the shaft 28 Will lie within the needle 14 to prevent pieces of tissue or other impedimenta from becoming lodged in the needle. Once the needle 14 is in position, the stylet is withdrawn and a removable valve 32 is seated in the chamber 12. The valve 32 is provided with a rather thin tubular injection needle 34 which, when in position, extends through the needle 14 substantially to its sharply beveled tip. As may be seen in the drawings, the outside diameter of the needle 34 is somewhat smaller than the inside diameter of the needle 14 so that an annular passage 36 exists between the two needles. The injection needle 34 is provided with an axial passage 35 in communication with an axial passage 37 formed in the valve 32 and serves as a passageway for the fluid being introduced to the body. If desired, a stylet (not shown) may be temporarily placed in the needle 34 While it is being inserted in the needle 14. A length of flexible tubing is attached to the ribbed outer end of the valve and connected to a source of pressurized gas or the like.

In FIG. 4, it will be seen that the valve 32 has a frusto-' conical portion 38 which seats snugly with the walls of the chamber 12. A groove 40 is milled in the inner end of the frusto-conical portion 38 which, when the valve 32 is in the position shown in FIGS. 4 and 5, will place the drain passage 24 in communication with the chamber 12 and the needle passage 36.

The drain extension 20 has its outer end formed with peripheral ribs and is normally attached to a rubber tubing connected to a suitable receptacle. The conduit traced from the tip of the needle 14 through the annular passage 36, the chamber 12, the groove 48 and the passage 24, constitutes a drain line through which the displaced spinal fluid is forced when pressurized gas is injected into the spinal subarachnoid space through the needle 34.

Draining through the passage 24 may be interrupted at any time by turning the valve 32 to one of the oil positions indicated in FIG. 5. To facilitate rotation of the valve 32, a handle 42 is provided.

Should it be desired to determine the spinal fluid pressure at any time, the valve 32 is turned 180 from. the position shown in FIGS. 4 and so that the groove 48 will be in communication with the passage 22. A small highly sensitive manometer (not shown) is normally connected to the extension 18 so as to give a visual indica tion of the fluid pressure admitted to the passage 22.

To allow for the collection of any spinal fluid which may be in a large glass type manometer, a draining system is provided between the manometer passage 22 and the drain 24. Referring again to FIGS. 4 and 5, a peripheral channel 44 is formed near the inner end of the valve 32 and extends approximately 200 about its circumference. Rotation of the valve member 32 at 90 in either direction from{ its position of FIG. 5 will place the channel 44 in alignment with the manometer passage 22 and the drain passage 24. Whatever fluid rnlay be in the manometer passage will then be drained oif and collected with the remainder of the fluid.

The various operating positions of the valve are indicated by radial lines in FIG. 5. Similar marks may be inscribed on the rear face of the housing \10. As indicated, there are four off positions, two positions for draining the manometer, one position for the manometer connection and one for the needle drain connection.

In FIG. 6, there is shown a modification of the device. In this embodiment, a solid rotatable valve 48 is used in place of the tubular valve 32 of FIGS. 3 and 4. The valve seating portion and the handle have the same outer configuration as the valve 32. It will be understood that when using the valve 48, there will be one needle in the instrument as against the double needle arrangement of the FIG. 4 embodiment. As in the valve 32, the valve piece 48 of FIG. 6 is provided with a manometer drain channel 50, and a groove 52 for selectively aligning the needle passage 36 with the drain 24 or the manometer. A link chain 54 or other suitable fastener may be provided between the valve 48 and the neck of the housing 10 to keep the valve readily available when needed. A small spring clip (not shown) attached to the side of the hub may be provided to temporarily support the detachable valve piece during insertion of the needle into tissue.

In FIGS. 7 and 8, there is shown the further modification of the lumbar puncture needle. The housing 10 and needle 14 are the same as those of the previous embodiments but in this instance there is a sealing valve 56 provided with a quick-closing plunger valve 58. As in the first two embodiments, the insertable portion of the valve 56 is provided with a peripheral manometer drain groove and a longitudinal channel fior draining and for pressure recording. An axial passage 60 extends through the valve port and terminates at its outer portion in a conical recess 62.

Arranged at a right angle to the axial passage 60 and intersecting it is the plunger 58 which is urged normally upward by a coil spring 64. An opening 66 is provided in the plunger and aligned with the passage 60 when the plunger is depressed. A stop 68 is provided to limit the position of the plunger and to prevent it from rotating about its axis. 1

In practice, the valve 56 is placed in the housing 10 prior to performing the puncture. The plunger 58 is depressed and a stylet 70 (FIG. 8) is inserted to prevent clogging of the needle passage 36 during the puncture. When the needle is in place, the stylet is withdrawn and the plunger allowed to close to prevent the escape of fluid. A tubular air-injection needle connected to a conically faced nozzle 74 is then inserted, the plunger being first depressed manually. E I

The nozzle 74 is provided with an axial passage 76 and may be connected to a source of pressurized gas through a length of flexible tubing. It will be obvious that from this arrangement, the injection passage will be automatically closed when the stylet or injection needle is not in place. This will prevent the accidental loss of spinal fluid that may back up' into this passage.

Referring now to FIGS. 9 and 10', there is shown a ventricular surgical needle with the several members being organized about an annular hub or housing 78. A tubular needle so is fitted to the tip of the hub and connects with a frusto-conical chamber 82 formed axially within the hub. Projecting radially outwardly from the hub is a stem 84, with a drain passage 86 formed therein and communicating with the chamber 82. An insertable valve 88 is shown in its proper operating position in FIG. 9. An axial passage 90' extends through this valve and communicates with an axial passage running through 'an injection needle 94 attached to the valve 88. As in the previous instances, the valve 88 is rotatable about its axis so that the drain 86 may be connected to the chamber 82 through a groove 96 fashioned on the frusto-conical seat of the valve. Rotation of the valve from the position shown will operate to close 011 the drain 86 when desired. A handle may be provided to facilitate manipulation of the valve.

In practice, when an opening has been prepared in the bone of the skull and in the membranes covering the surface of the brain, the needle 80 with the stylet 100 in place is passed through the substance of the brain into a ventricular cavity. Once the device has been positioned properly with respect to the ventricular chamber, the stylet is withdrawn and replaced by the injection needle M and valve 88. It will be seen that the needle 80 is formed with a rounded closed tip and has a pair of spaced ports disposed on the side thereof. The opening 102 nearest the tip appears opposite to the end of the injection needle and constitutes an inlet for the gas or other substances being introduced to the ventricular chamber. The port 164 located rearwardly of the port 102 serves as an outlet for the ventricular fluid being displaced by the injected gas. The fluid will pass back through the needle 80 into the chamber 82 through the groove '96 thence to the drain 86 into a suitable receiver.

An aspiration and irrigation needle, somewhat similar to the needle of FIG. 9, is illustrated in FIGS. 11 to 14. In this embodiment, the housing 78 is provided with a tubular needle 106 characterized by a closed tip with oppositely facing ports spaced from one another at the distal end. The outermost opening 108 is in the form of a rather narrow slit out transversely across the needle and located adjacent to the end of the injection needle 104 when that needle is in position. This opening serves as an inlet port for the needle while the opening 110, being circular and somewhat larger, and located rearwardly of the inlet, serves as an outlet or drain for the fluid. It will be seen that a collar 112 is secured about the end tip of the injection needle to serve as a baffle between the injection port 108 and the drain 110. A small hole 114 may be drilled through the collar through which a portion of the injected liquid may flow to help wash the displaced body fluid back through the needle 106. As before, a stylet 116 may be temporarily placed in the hub during the puncture and prior to insertion of the valve 88.

One advantage of this construction is that the valve seating may be changed without any lateral or other displacement of the instrument since the valve is rotatable about the axis of the needle. This advantage continues during the assembly and disassembly of the stylets and the valve since they are moved along the needle axis. Also it will be appreciated that the instrument may at any time be converted from a single needle affair to a double needle device or vice versa as the need arises without withdrawing the instrument from the tissue or without producing any excessive movement of the needle. These considerations are important to the welfare and/ or survival of the patient since unnecessary or excessive puncturing or lacerations of the tissues enclosing and surrounding the fluid are to be avoided with the greatest diligence.

By organizing the manometer connection directly with the needle housing, considerable weight is saved since intermediate adaptors and stop cocks previously used are eliminated. This is an important advantage over other types of fittings, since a heavy ended needle may readily be dislodged or may tear brain tissue.

In FIG. 15 there is illustrated a lumbar puncture needle in which the housing It is provided with a tubular needle 121 having a blunt open end with a radial aperture 122 formed adjacent the end. An insertable valve piece 124 is mounted within the housing and supports a solid stylet 126. The stylet 126 extends through the needle 129 so that its sharply beveled point projects out through the open end. A peripheral recess 128, of perhaps 200 arc, is formed near the end of the stylet 126 and arranged to align with the aperture 122 when in the position shown in FIG. 15. This recess communicates with a longitudinal groove 130 milled along the outer surface of the stylet 126 to define a single passage between the stylet and the needle 120. The groove terminates in the chamber 12 of the housing 10 and may be directed through a valve opening 132 either to the drain passage 24 or the manometer connection 22 by rotating the valve piece 124 to the desired position. As before, the valve piece 124 is provided with a manometer drain passage 134 operated by proper rotation of the valve.

In FIGS. 16a, 16b, and 160 the various operating positions of the device are shown. In FIG. 16a, for instance, the stylet and valve are shown in the drain position. Body fluid entering the aperture 122 will flow through the recess 128, through the groove 130, thence through the port 132 to the drain passage 124. In FIG. 16b, the valve and stylet have been rotated 180 to bring the opening 132 into alignment with the manometer passage 22. It will be noted that in both cases the recess 128 remains in communication with the aperture 122. In FIG. 160, the aperture 122 has been closed off by a 90 rotation of the valve. This adjustment also serves to line up the manometer drain. Preferably, the aperture should be closed off as in FIG. 16c whenever'a puncture is being performed to prevent bits of tissue from becoming lodged in the instrument.

In FIG. 17 there is illustrated a modification of the FIG. 15 embodiment. In this' instance, the grooved stylet is'replaced by a tubular needle 136 having open-' ings 1'38 and 140 formed at opposite ends. The distal opening 140 passes through both sides of the needle 136 so that rotation of the valve 180 from its position shown will connect the aperture with the manometer. The outer needle in this case is provided with .its own sharply beveled point and an aperture 142 corresponding to the aperture 122 of the FIG. 15 device. In FIG. 18, there is shown a lumbar puncture needle having a retractable point; A valve housing, somewhat similar in appearance to the valve housing 78 of FIGS. 9 and 11, is provided with cam threads 146 engaging with cam threads 148 of an insertable valve piece 150. The valve piece supports a tubular member 152 extending through a tubular needle 154. The needle has a radial aperture 156 adapted to communicate with an axial passage 157 extending through the member 152 when aligned with an opening 159, fashioned near the tip. It will be understood that when the member 152 is in its extended position, shown in FIG. 18, the aperture 156 is closed off and a puncture may be made. Once in position, this valve piece is rotated a full turn, thereby retracting the point to avoid accidental injury to surrounding tissue, and at the same time aligning the opening 159 with the aperture 156. The fluid will then flow through the passage 157 out through an opening 158 and through a drain passage 160.

Referring now to FIGS. 19-23, there is shown two improved surgical needle tips, particularly suitable for use with the type of surgical instrument described herein.

In the embodiment of FIGS. 19 and 20, a tubular needle 162 of annular cross-section merges into a top portion 164 of generally rectangular cross section to form a shoulder 166 a short distance back from the tip. Surgical needles of conventional design usually produce a round puncture which does not readily heal when the needle is withdrawn. As a result, a certain amount of fluid will escape before the puncture is healed over and is some cases this loss may adversely effect the patients condition.

By providing a needle tip, such as that shown in FIG. 19, the risk of fluid loss through the puncture is substantially reduced. In practice, the orientation of the tissue fibres of the spinal cord, for example, are first determined. The needle is then inserted so that the tip opening is lengthwise with respect to the fibres so that the fibres will be spread apart rather than pierced as by a conventional tip. When the needle is withdrawn, the fibres will return to their original condition with very little if any loss of fluid. The shoulder 1 66 serves as a stop for the needle to keep it from being pushed too far into the cavity and perhaps injure an opposite wall.

In FIGS. 2l-23, there is shown a needle 16% somewhat similar to that of FIGS. 18 and 19, but in this case the tip portion 170 is generally elliptical in cross section and transverse, recesses 172 are formed at the base of the shoulder 174 on opposite sides of the needle.

When the needle is insereted so that the shoulder is butt against the cavity wall, the membrance (reference character 176 in FIG. 23) which has been spread apart by the tip, will engage the grooves and hold the needle in its proper operating position. This arrangement thus prevents accidental dislodgement of the instrument and avoids injuring the surrounding tissue.

While I have described my invention with particular reference to the various embodiments shown, I am aware that a great many modifications will appear to those skilled in the art without departing from my invention.

Having thus described my invention, what I claim and desire to obtain by Letters Patent of the United States is:

1. A surgical needle comprising a valve housing formed with a first passage extending therethrough and with at least two branch passages for exterior communication with said first passage, an elongated outer tubular needle mounted on said valve housing and forming a passage communicating with said first passage, a valve member having a further passage formed therethrough -for exterior communication, said valve member being removably received in peripheral sealing engagement in said first passage, means for selectively moving said valve in said first passage, an inner tubular needle mounted on said valve member and communicating with said further passage in said valve member, said outer needle receiving said inner needle in an assembled relation of said valve member in said first passage, said valve member being formed with means for selectively connecting said passage in said outer needle with either one of said branch passages in selected positions of said valve member.

2. A surgical needle as recited in claim 1, in which said outer needle forms an annular passage about said inner needle in communication with said first passage in said valve housing.

3. A surgical needle comprising a valve housing formed with a firstpassage extending along an axis therethrough and with at least two branch passages for exterior communication with said first passage, an elongated outer tubular needle mounted along said axis on said valve housing and forming a passage communicating with said first passage, a valve member having a further passage extending along said axis therethrough for exterior communication, said valve member being removably received in peripheral sealing engagement in said first passage, means for selectively rotating said valve about said axis in said first passage, an inner tubular needle mounted along said axis on said valve member and communicating with said further passage in said valve member, said outer needle receiving said inner needle in an assembled relation of said valve member in said first passage, said valve member being formed with means for selectively connecting said passage in said outer needle with either one of said branch passages in selected rotary positions of said valve. member.

4. A surgical instrument for simultaneously injecting and extracting fluids from the human body, comprising a hub, a passage extending along an axis through said hub, a tubular surgical needle extending along said axis from said hub in communication with said passage, a valve member, a further passage extending along said axis through said member, a tubular injection needle extending along said axis from said member in communication with the passage formed therein, the passage in said hub removably receiving said valve member for rotation about said axis, said injection needle being disposed coaxially Within said surgical needle when said member is received therein, the outside diameter of said injection needle being smaller than the inside diameter of said surgical needle to define an annular drain passage between said needles in communication with said passage in said hub, and a drain port formed in said hub and opening into said passage thereof, said valve member normally closing said drain port and being formed with a groove open to said drain passage for selectively communicating said drain port with said drain passage by selective rotational movement of said valve member therein.

5. A surgical instrument according to claim 4 wherein said hub is further provided with a second port opening into said passage thereof, said second port being normally closed by said valve member and being selectively communicable with said drain passage through said groove by selective rotational movement of said valve member.

6. A surgical instrument according to claim 5 wherein said valve member is provided with a channel for selec tively connecting said second port with said drain port by selective rotational movement of said valve member to positions in which said valve member closes communication of said groove with either of said ports, the body of said valve member closing said channel against communication with said drain passage in all rotational positions.

7. A surgical instrument according to claim 4, wherein said valve member is provided with means normally closing ofi said further passage formed therein, said means being movable to open said further passage.

8. A surgical instrument -for selectively draining fluids from body cavities and for recording the pressure of a body fluid, comprising a hub, a passage formed along an axis through said hub, a tubular surgical needle extending axially from said hub and communicating with said passage, a valve member received conformably in said passage for rotation about said axis, said valve member being formed with a surface groove extending to an end thereof along said axis to communicate with said passage, and with a surface channel closed from communication with said groove by the body of said valve member and extending arcuately about said axis, the body of said valve member further closing communication between said channel and said passage, said hub being provided with a drain conduit and a further conduit adapted to connect with a pressure-sensing device, said conduits opening into said passage and normally being closed by said valve member, each of said conduits being selectively communicable with said passage through said groove and alternatively with one another through said channel, by selective rotational movement of said valve member.

9. A surgical instrument for selectively draining fluid from a body cavity and for recording the pressure of a body fluid, comprising a hub having a passage formed along an axis therethrough, a drain conduit and a pressure recording conduit formed in said hub and opening into said passage, a tubular needle extending axially from said hub, said needle being provided near its tip with a radial aperture, a movable valve member received conformably and rotatably in said passage, an elongated shaft secured to said valve member and extending in fluid-sealing peripheral engagement into said needle, said shaft being formed with a longitudinal passage in communication with the passage in said hub and with radial openings near its tip for registration with said aperture in different rotational positions of said shait in said needle, said valve member normally closing communication between said conduits and said passage, and being formed with a groove for selectively communicating said openings with either of said conduits in said different rotational positions of said valve member.

10. A surgical instrument according to claim 9 wherein said longitudinal passage is a groove formed along the surface of said shaft and merging into a peripheral recess of less than 360 are formed near the tip of said shaft.

11. A surgical instrument according to claim 9 wherein said longitudinal passage is an axial conduit through said shaft and terminating in radial openings formed at opposite ends of the shaft.

12. A surgical instrument for draining fluids from body cavities, comprising a hub having a passage formed along an axis therethrough, the walls of said passage being formed with cam surfaces, a drain conduit in said hub communicating with said passage, a tubular needle mounted on and extending axially from said hub, a radial aperture formed near the tip of said needle, a movable valve member mounted in said passage and provided with cam surfaces operatively engaged with the cam surfaces of said hub, a tubular shaft mounted on said member and extending axially through said needle in fluid-sealing peripheral engagement therewith, said shaft having a pointed tip, said shaft being provided with radial openings at opposite ends thereof in communication with a passage extending through said shaft, said valve member being rotatable in one direction to cause said engaged cam surfaces to move said valve member axially and thus to extend said pointed tip beyond the end of said needle and to interrupt communication between said aperture in said needle and one of said openings in said shaft, and in an opposite direction to cause said engaged cam surfaces to move said valve member in an opposite axial direction and thus to align said one of said openings with said aperture and to retract said tip.

References Cited in the file of this patent UNITED STATES PATENTS 2,396,351 Thompson Mar. 12, 1946 2,630,803 Baran Mar. 10, 1953 2,646,042 Quang Hsi Hu July 21, 1953 2,830,587 Everett Apr. 15, 1958 2,854,027 Kaiser et a1 Sept. 30, 1958 2,899,959 Ginsburg Aug. 18, 1959 FOREIGN PATENTS 575,559 France Apr. 24, 1924 1,092,011 France 'Nov. 3, 1954 

8. A SURGICAL INSTRUMENT FOR SELECTIVELY DRAINING FLUIDS FROM BODY CAVITIES AND FOR RECORDING THE PRESSURE OF A BODY FLUID, COMPRISING A HUB, A PASSAGE FORMED ALONG AN AXIS THROUGH SAID HUB, A TUBULAR SURGICAL NEEDLE EXTENDING AXIALLY FROM SAID HUB AND COMMUNICATING WITH SAID PASAGE, A VALVE MEMBER RECEIVED CONFORMABLY IN SAID PASSAGE FOR ROTATION ABOUT SAID AXIS, SAID VALVE MEMBER BEING FORMED WITH A SURFACE GROOVE EXTENDING TO AN END THEREOF ALONG SAID AXIS TO COMMUNICATE WITH SAID PASSAGE, AND WITH A SURFACE CHANNEL CLOSED FROM COMMUNICATION WITH SAID GROOVE BY THE BODY OF SAID VALVE MEMBER AND EXTENDING ARCUATELY ABOUT SAID AXIS, THE BODY OF SAID VALVE MEMBER FURTHER CLOSING COMMUNICATION BETWEEN SAID CHANNEL AND SAID PASSAGE, SAID HUB BEING PROVIDED WITH A DRAIN CONDUIT AND A FURTHER CONDUIT ADAPTED TO CONNECT WITH A PRESSURE-SENSING DEVICE, SAID CONDUITS OPENING INTO SAID PASSAGE AND NORMALLY BEING CLOSED BY SAID VALVE MEMBER, 